State RegulationsIL specificDifficulty 3/5
A company wants to market a plan in Illinois that covers only dental services and nothing else. Under Illinois law, which regulatory characterization applies?
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
The defining feature of a limited health service organization under 215 ILCS 130/1002 et seq. is that it provides or arranges only specified, limited health services. A dental-only plan fits that model rather than the comprehensive HMO framework of 215 ILCS 125/1-2, and it remains subject to Illinois insurance regulation, including the LHSO Act's organization and operating provisions running from 215 ILCS 130/3001 through 215 ILCS 130/4003, under the Illinois Department of Insurance.
Why the other options are wrong
- A) Dental-only coverage does not make the plan an HMO; the HMO Act at 215 ILCS 125/1-2 governs comprehensive health maintenance organizations, while limited-service plans fall under 215 ILCS 130/1002 et seq.
- C) Dental-only plans are insurance products subject to Illinois regulation; the LHSO Act exists precisely to regulate them.
- D) Medicare supplement policies and the guaranty association act are unrelated to the characterization of a dental-only plan.
Memory hook
One service line = LHSO (215 ILCS 130/1002 et seq.); full service = HMO (215 ILCS 125/1-2).